Abstract
Abstract Background Advanced Nurse Practitioners (ANP) for Older Persons have advanced clinical skills and work with the Multidisciplinary Team, patients and carers. They practice with a high degree of autonomy under the clinical governance of a Geriatrician. These new roles have been developed in line with the emergence of clinical care pathways and an ageing population. Many are in the area of frailty assessment in the Emergency Department setting. This audit examined the development of the role of Older Persons ANP in a level three hospital. Methods Inclusion and exclusion criteria for ANP caseload were developed. ANP referral pathways were established. Referrals and interventions were captured by Audit. Data collection was both quantitative and qualitative Results Referrals to the ANP are generated in ED using a Variable Indicator of Placement (VIP) score and via consults from medical teams. 245 inpatients aged over 75 years were seen in 2021. Half referrals were generated by VIP and the other half by consult. Clinical Frailty Scale (CFS) of patients ranged from 4 to 9 but were predominantly 6,7 and 8. The ANP undertook a comprehensive geriatric assessment for these patients. Interventions included medication adjustment, social assessment and specialist advice to the MDT. The ANP “pulls the story together” (Cowley, 2016) providing a holistic link between all parties. Ongoing support is provided in an outpatient setting. Conclusion The ANP is well placed to lead holistic care for older people in conjunction with the MDT. In this level three hospital, the ANP role has made a significant impact on the wards as part of the wider specialist geriatric team. This is novel in that many hospitals to date have placed the role in the ED. Variables such as impact on patient outcome, length of stay, readmission rates and service quality are worthy of exploration as the service progresses.
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